Blood Test May Indicate Risk for Coronary Event

The study, part of the Women’s Health Initiative (WHI), was conducted nationwide and included 271 cases of coronary heart disease in the first four years of the trials of estrogen alone and of estrogen plus progestin. “Because studies on hormone therapy have shown that they may increase heart attacks and strokes, many women have been reluctant to use this treatment,” said Paul F. Bray, M.D., Director, Division of Hematology at Jefferson Medical College of Thomas Jefferson University.

The study looked at levels of blood lipids and high sensitivity C-reactive protein (hsCRP) in women who did not have any previous cardiovascular disease. The results indicate those who entered the study with favorable cholesterol levels were not at increased risk of developing heart problems while taking hormones (estrogen alone or estrogen plus progestin), whereas women with unfavorable cholesterol levels were at a greater risk of having heart related complications.

Specifically, women with ratios of “bad” cholesterol to “good” cholesterol less than 2.5 did not appear to be at an increased heart disease risk when using hormone therapy. On the other hand, it is known that women with higher ratios of “bad” to “good” cholesterol were at higher risk of coronary heart disease, and this study shows that risk is magnified if they take hormone therapy. Elevated hsCRP appeared to predict higher risk in women taking estrogen, but not in women taking estrogen plus progestin compared to a placebo.

“This report only considered the effects of hormone therapy on coronary disease outcomes,” added Bray. “Instead of genetic testing or another more complicated test, we wanted to find a simple and effective way to assess the heart risk of hormone therapy. However, it should be noted that the WHI investigators have not found this test helpful in predicting the risk of stroke due to hormone therapy.; Source: Thomas Jefferson University